Clerkship Resources

Clerk­ship is a trans­for­ma­tive two-year jour­ney where stu­dents shift from class­room learn­ing to hands-on clin­i­cal train­ing, refin­ing their med­ical knowl­edge and inter­per­son­al skills in real health­care set­tings.

Year 3 begins with M4 – Tran­si­tion to Clerk­ship, a 3‑week peri­od that serves to accli­mate stu­dents to the clin­i­cal duties and sce­nar­ios they will soon encounter, incor­po­rat­ing tuto­ri­als, sim­u­la­tions, and real patient encounters.

Stu­dents are divid­ed into 8 tracks to rotate through M5 – Core Clin­i­cal Rotations.

Core rota­tions are fol­lowed by M6 – Elec­tives and CaRMS. Stu­dents have 14 weeks of elec­tive rota­tions, which must include at least three dif­fer­ent dis­ci­plines. Dur­ing this time, stu­dents also work on their CaRMS appli­ca­tions in prepa­ra­tion for the 3‑week CaRMS Inter­view peri­od. This mod­ule clos­es with the CCE, an OSCE-style exam­i­na­tion in the sim­u­la­tion lab.

The med­ical school expe­ri­ence con­cludes with M7 – Tran­si­tion to Res­i­den­cy, dur­ing which stu­dents are pro­vid­ed with addi­tion­al oppor­tu­ni­ties to refine their skills before com­menc­ing res­i­den­cy. This includes two 3‑week blocks of selec­tives intend­ed to empha­size com­mu­ni­ty and out­pa­tient activ­i­ties. Sand­wiched between the two selec­tive blocks is Match week – a week focus­ing on team build­ing, lead­er­ship, and what to expect in the com­ing years. Addi­tion­al­ly, stu­dents are giv­en the day off to cel­e­brate on Match Day. There are also for­mal teach­ing ses­sions each Fri­day after­noon through­out the selec­tive blocks, cul­mi­nat­ing in a writ­ten paper and pre­sen­ta­tion in the sev­enth week. The year con­cludes with a com­pre­hen­sive course review and an ACLS course to help stu­dents pre­pare for the MCC­QE Part I.

Each rota­tion will have:

• MITER (Mid-point In-Train­ing Eval­u­a­tion Report) – At the mid-point of each rota­tion, stu­dents score them­selves on entra­da in key per­for­mance areas and write com­ments about their strengths and weak­ness­es. The MITER is then dis­cussed with one of your pre­cep­tors or the rota­tion head. MITERs are for­ma­tive, and rota­tions that are short­er than 4 weeks have a FITER only.
• FITER (Final In-Train­ing Eval­u­a­tion Report) – At the end of each rota­tion, pre­cep­tors or rota­tion heads fill out the same report about each stu­dent and dis­cuss it with them. FITERs yield the over­all Pass/​Borderline Pass/​Fail grade for the rota­tion as a whole. The com­ments from your FITER appear on your Med­ical Stu­dent Per­for­mance Record (MSPR), which pro­grams view for CaRMS. The MSPR does not show your numer­i­cal scores from your rotations.
• Essen­tial Clin­i­cal Pre­sen­ta­tions (ECPs) – A list of patient symp­toms and med­ical pro­ce­dures that you must be exposed to over the course of the rota­tion. These are tracked in your log­book on entrada.
• NBME Exam­i­na­tions – Surgery, Pedi­atrics, Obstetrics/​Gynecology, Inter­nal Med­i­cine, Fam­i­ly Med­i­cine, and Psy­chi­a­try each con­clude with an online mul­ti­ple-choice exam­i­na­tion. These tests are pass/​fail, with a pass­ing grade des­ig­nat­ed as the 11^th per­centile nation­al­ly. An NBME fail­ure does not con­sti­tute a rota­tion fail­ure, and vice ver­sa – they are mutu­al­ly exclu­sive. Only pass/​fail appears on your MSPR, not your numer­i­cal score.

Dur­ing clerk­ship, each rota­tion has its own call shift expec­ta­tions. Call sched­ules are usu­al­ly cre­at­ed by senior res­i­dents or depart­ment coor­di­na­tors and can vary by spe­cial­ty.

If you know in advance that you can’t take call on a spe­cif­ic date, it’s best to noti­fy the depart­ment admin­is­tra­tor at least 6 weeks before your rota­tion begins. This helps ensure the sched­ule can be built with your needs in mind.

Once the sched­ule is set, if a con­flict aris­es, you may try to trade call shifts with anoth­er stu­dent or res­i­dent — but this must be approved by the sched­ule coordinator.

If you’re on call for 8 hours or more on a statu­to­ry hol­i­day, you’re enti­tled to one extra post-call day. This day must be tak­en dur­ing the same rota­tion. Emer­gency Depart­ment shifts on stat hol­i­days do not count as ​“on call.”

Plan ahead, com­mu­ni­cate ear­ly, and be proac­tive with any con­flicts — call sched­ul­ing runs smoother for every­one that way!

We under­stand that life hap­pens. Whether you’re plan­ning ahead or fac­ing an unex­pect­ed sit­u­a­tion, here’s what you need to know about absences dur­ing clerkship.

Antic­i­pat­ed Leaves

If you’re plan­ning to be away (e.g. trav­el, per­son­al com­mit­ments, reli­gious observances):

• Sub­mit a Leave of Absence (LOA) request through Entrada.
• Do not make trav­el or per­son­al arrange­ments until your leave is offi­cial­ly approved.
• Once approved by the Clerk­ship Direc­tor and pro­gram, it’s your respon­si­bil­i­ty to noti­fy your ser­vice in advance and again the day before your LOA begins.
• Chief res­i­dents may not be informed of your LOA, so it’s impor­tant to keep them in the loop — espe­cial­ly if they’re cre­at­ing your call schedule.
• Some rota­tions may ask about dates you’d like off ear­ly on. Please respond hon­est­ly and promptly.

If you’re already sched­uled for a call shift, it’s expect­ed that stu­dents arrange a switch with anoth­er stu­dent or res­i­dent, sub­ject to the sched­ule coordinator’s approval.

Short­er Absences

For brief, antic­i­pat­ed com­mit­ments (e.g. med­ical appoint­ments, per­son­al meetings):

• An offi­cial LOA is not required.
• Speak with your super­vi­sor and email the rotation’s admin assis­tant to coordinate.

Recur­ring appoint­ments may require for­mal LOA approval.

Unan­tic­i­pat­ed Absences

If some­thing unex­pect­ed hap­pens (e.g. ill­ness, emer­gency, car accident):

• Con­tact your direct super­vi­sor imme­di­ate­ly to inform them of the situation.
• Noti­fy the UGME office as well — espe­cial­ly if you’ll miss more than 2 days.

If you’re absent due to ill­ness for more than 2 days, stu­dents must sub­mit a med­ical note to UGME.

Atten­dance Guidelines

• No more than 25% of any rota­tion may be missed for any rea­son. Exceed­ing this lim­it will result in hav­ing to repeat the rotation.
• Stu­dents are allowed a max­i­mum of 6 approved LOAs per aca­d­e­m­ic year.
• Unap­proved absences are not tol­er­at­ed and may be treat­ed as a fail­ure of pro­fes­sion­al responsibility.

For full details, please review the Clerk­ship Atten­dance Pol­i­cy, includ­ed below.

While there’s no secret for­mu­la for nav­i­gat­ing elec­tives or CaRMS, here are a few friend­ly pieces of advice we’ve gath­ered from upper-year students.

Plan­ning Ahead

• Start ear­ly! Things can change fast, and oppor­tu­ni­ties fill up quickly.
• Cre­ate a wish­list of elec­tives you’d like to do, and reg­is­ter on the AFMC Stu­dent Por­tal in May of your third year
• Ask for ref­er­ence let­ters as you go — don’t wait until the end.
• Begin draft­ing your CV and per­son­al let­ters well in advance of the CaRMS por­tal open­ing. You’ll thank your­self later.
• Build Men­tor­ship & Learn from Others
• Talk to res­i­dents at dif­fer­ent stages of train­ing — what do they love or find chal­leng­ing in their pro­gram or specialty?
• Con­nect with both junior and senior staff — they often offer dif­fer­ent perspectives.
• Keep a jour­nal. Use it to record mean­ing­ful moments, patient encoun­ters, and thoughts — it becomes a valu­able resource when it’s time to write per­son­al state­ments or pre­pare for interviews.

Gen­er­al Tips for Clerk­ship and Beyond

• Be pro­fes­sion­al. Dress appro­pri­ate­ly, be punc­tu­al, and stay respectful.
• Live by the Gold­en Rule. Kind­ness mat­ters — treat every­one with respect, from patients to staff to colleagues.
• Ask ques­tions. You’re here to learn, and there’s no such thing as a ​“dumb” question.
• Jour­nal, jour­nal, jour­nal. (Yes, we’re say­ing it again — it’s that helpful.)
• Offer help when you can. Vol­un­teer­ing to take on small tasks shows ini­tia­tive. Just speak up if your respon­si­bil­i­ties become too menial or unbalanced.
• Make time for your hob­bies. Stay­ing con­nect­ed to your inter­ests out­side med­i­cine keeps you grounded.
• Get sleep. It’s not a lux­u­ry — it’s a neces­si­ty. Pri­or­i­tize rest when­ev­er you can.

These tips aren’t one-size-fits-all, but we hope they make your jour­ney a lit­tle smoother. You’ve got this.

Med­ical School can be incred­i­bly chal­leng­ing, but it should also be a pos­i­tive and reward­ing expe­ri­ence. You can’t prop­er­ly learn or care for oth­ers if you don’t care for your­self.

Be sure to also vis­it our Well­ness page for tips on per­son­al well­ness. When in doubt, con­tact Dr. Avi­va Gold­berg, Dean of Stu­dent Affairs – she’s the best! We at the MMSA are also here for you. Please feel free to drop us a line any­time if you’d like to speak with a peer.